| NPI | 1093114050 |
|---|---|
| Former Name | ALYSSA RAE DOUGHTY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0222X Nurse Practitioner Pediatrics, Critical Care (Licence: WI 5928-33) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 179985) |
| Enumeration Date | 2014-08-15 |
| Last Update Date | 2015-10-02 |